Automatic mean blood pressure reading device

• US 4,360,029 A
• Filed: 10/03/1980
• Issued: 11/23/1982
• Est. Priority Date: 04/10/1978
• Status: Expired due to Term

• Current Assignee: Critikon Co. LLC
• Original Assignee: Johnson & Johnson
• Inventors: Ramsey, Maynard III
• Primary Examiner(s): Howell, Kyle L.
• Assistant Examiner(s): Jaworski, Francis J.
• Application Number:
  US06/193,866
• Time in Patent Office: 781 Days
• Field of Search: 128/680-683
• US Class Current: 600/494
• CPC Class Codes: A61B 5/02141 Details of apparatus construction, e.g. pump units or housings therefor, cuff pressurising systems, arrangements of fluid conduits or circuits A61B5/02233, A61B5/0235 take precedence
• CPC Class Codes: A61B 5/022 by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers
• CPC Class Codes: A61B 5/02225 using the oscillometric method
• CPC Class Codes: A61B 5/7239 using differentiation including higher order derivatives

Abstract

An apparatus for producing information indicative of the mean blood pressure of a living creature through indirect measurement comprising an inflatable cuff, a pump connected to the cuff, a deflating valve connected to the cuff, measuring apparatus connected to the cuff adapted to measure cuff pressure and pressure oscillations occurring in the cuff caused by the heartbeat of the living creature and control apparatus connected to the pressure measuring apparatus, pump and deflating valve. Deflation of the cuff occurs in pressure increments, with processing being done at each given decrement to evaluate plural successive pulsations for purposes of artifact rejection and identification of a true pulsation.

Claims

1. Apparatus for producing information indicative of the mean blood pressure of a living subject through indirect measurement comprising:

(a) inflatable, deflatable cuff means;

(b) pump means, connected to said cuff means, for inflating said cuff to a pressure above systolic pressure of said subject;

(c) deflating means, connected to said cuff means, for controlled deflation of said cuff means;

(d) means for measuring cuff pressure and, at a given cuff pressure, pressure pulsations in said cuff means caused by heartbeats of said subject;

(e) control means, responsive to said means for measuring, for initially energizing said pump means to inflate said cuff, and for subsequently energizing said deflating means incrementally to deflate said cuff at predetermined pressure increments;

(f) wherein said measuring means includes;

(i) means for detecting, for each successive set of said pulsations occasioned by successive heartbeats, pulsation amplitude and pulsation time rate of change,

(ii) means for identifying, at each of said cuff pressure increments, the occurrence of at least two successive sets of pulsations which meet predetermined amplitude and time rate of change criteria relative to one another,

(iii) means, responsive to said means for identifying, for energizing said control means to deflate said cuff by an increment upon identification of said occurrence of pulsations within said criteria, and

(iv) means, responsive to said means for identifying, for comparing specified peak to peak amplitude factors of identified pulsations at successive cuff pressure increments; and

(g) output means, responsive to said means for comparing, for indicating mean blood pressure as the lowest cuff pressure increment corresponding to the largest of said specified peak-to-peak amplitude factors.

2. An apparatus in accordance with claim 1 and further including adjustable means for storing an upper limit and a lower limit for said mean arterial pressure, means for comparing said upper limit and said lower limit with the mean arterial pressure indicated by said output means, and alarm means responsive to said comparing means for indicating occurrence of a measured mean arterial pressure above said upper or below said lower limit.

3. An apparatus in accordance with claim 1 including means responsive to said means for measuring for fully deflating said cuff means when said cuff pressure has been reduced below a predetermined minimum.

4. An apparatus in accordance with claim 3 and further including counter means, responsive to said means for measuring, for energizing said means for deflating after a predetermined number of cuff pressure increments following the measurement of said maximum peak-to-peak average value.

5. An apparatus in accordance with claim 3 and further including adjustable time delay means for restarting the apparatus a predetermined time after the most recent indication by said output means.

6. An apparatus in accordance with claim 3 including means for counting the number of pressure pulsation signals occurring at each of said pressure increments and for fully deflating said cuff means when the number of pressure pulsation signals at said increment is in excess of a predetermined maximum.

7. An apparatus in accordance with claim 1 including an overpressure switch connected to said cuff means for actuating said deflating means to fully deflate said cuff means when said cuff pressure is in excess of a predetermined maximum.

8. An apparatus in accordance with claim 1 wherein said measuring means includes a pressure transducer responsive to the pressure in said cuff means to produce an output voltage signal representative of said cuff pressure and said pressure pulsations.

9. An apparatus in accordance with claim 1 wherein said means for detecting includes means for isolating fluctuating signal components from d.c. signal components of said pulsations, and means for selectively processing said components in digital fashion.

10. Apparatus as described in claim 1 wherein:

(a) said means for detecting includes means for evaluating the time derivative of said pulsations;

(b) said means for identifying includes;

(i) means for comparing said time derivative with a predetermined threshold,

(ii) means for detecting the pulsation peak next after said derivative exceeds said threshold,

(iii) means for comparing successive ones of said detected pulsation peaks; and

(c) said means for identifying includes means for averaging successive said peaks which are within predetermined differentials of each other, to produce an average peak value defining said amplitude factor.

11. Apparatus for producing information indicative of the mean blood pressure of a living subject through indirect measurement comprising:

(a) inflatable, deflatable cuff means;

(b) pump means, connected to said cuff means, for inflating said cuff to a pressure above systolic pressure of said subject;

(c) deflating means, connected to said cuff means, for controlled deflation of said cuff means;

(d) means for measuring cuff pressure and, at a given cuff pressure, pressure pulsations in said cuff means caused by heartbeats of said subject;

(e) control means, responsive to said means for measuring, for initially energizing said pump means to inflate said cuff, and for subsequently energizing said deflating means incrementally to deflate said cuff at predetermined pressure increments;

(f) wherein said measuring means includes;

(i) means for detecting, for each successive set of said pulsations occasioned by successive heartbeats, pulsation amplitude,

(ii) means for identifying, at each of said cuff pressure increments, the occurrence of at least two successive sets of pulsations which meet predetermined amplitude criteria relative to one another,

(iii) means, responsive to said means for identifying, for energizing said control means to deflate said cuff by an increment upon identification of said occurrence of pulsations within said criteria, and

(iv) means, responsive to said means for identifying, for comparing specified peak-to-peak amplitude factors of identified pulsations at successive cuff pressure increments; and

(g) output means, responsive to said means for comparing, for indicating mean blood pressure as the lowest cuff pressure increment corresponding to the largest of said specified peak-to-peak amplitude factors.